Osteomyelitis in a paediatric patient

Abstract

A paediatric patient presented through Urgent Care with arm pain and was referred for radiographic imaging to exclude a bony abnormality. Imaging appearances were grossly abnormal and consistent with an aggressive pathology; osteomyelitis and Ewing sarcoma were within the possible differentials. Fortunately, this was formally reported on the same day and escalation processes followed to enable timely, effective and safe patient management. The patient was referred for magnetic resonance imaging (MRI) and blood tests under the care of paediatrics; these investigations confirmed the diagnosis of subacute/chronic osteomyelitis. Appropriate antibiotic therapy and pain relief were provided by orthopaedics as an inpatient and then longer term as an outpatient. After a three-month period, this treatment was complete and the patient reattended for repeat blood tests and radiographs. The patient is now systematically well, their imaging shows marked improvement, and their blood test values are back within...